Individual provider Active NPI

Karen Kemp-Prosterman, DDS

  • Pediatric Dentistry
  • Farmington, CT
National Provider Identifier
1548368038
Registry record updated May 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
11044 Issued in CT
Practice address
263 Farmington Ave
Farmington, CT 06030
Phone
(860) 679-2207
Fax
(860) 679-1899
NPI assigned
Sep 20, 2006
Last updated
May 11, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 000033-1 NY
Pediatric Dentistry 1223P0221X 11044 CT Primary

Addresses

Primary practice location

263 Farmington Ave
Farmington, CT 06030

Mailing address

263 Farmington Ave
Farmington, CT 06030-3905
Phone (860) 679-2207

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kkempprosterman31082@direct.med.uchc.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180814003430 CT Order and Referring Only - DentistPractitioner - Dentist 0749539419

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11044CTMDSocial Worker
000033-1NYMDPediatric Dentist

Interoperability endpoints

  • Direct secure messaging: kkempprosterman31082@direct.med.uchc.edu
  • Direct secure messaging: kkempprosterman41722@connecticutchildrens.direct-ci.com

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620691200000",
    "number": "1548368038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060303905",
            "telephone_number": "860-679-2207",
            "fax_number": "860-679-1899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "06030",
            "telephone_number": "860-679-2207",
            "fax_number": "860-679-1899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEMP-PROSTERMAN",
        "first_name": "KAREN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2021-05-11",
        "certification_date": "2021-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "000033-1",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CT",
            "license": "11044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kkempprosterman31082@direct.med.uchc.edu",
            "affiliation": "N",
            "address_1": "263 Farmington Ave",
            "city": "Farmington",
            "state": "CT",
            "country_code": "US",
            "postal_code": "06030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Farmington, CT

Sources for this page

Verify at the official NPI Registry.